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NPI Code Detail

MEDICARE: MS. AMY KAY M.S., MFT

MEDICARE: MS. AMY KAY M.S., MFT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family Therapist40813CA

General Provider Information

NPI Number : 1295855021
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. AMY KAY M.S., MFT
Provider Business Mailing Address
First Line : 14135 RIVERSIDE DR
Second Line : UNIT 2
City : SHERMAN OAKS
State : CA
Zip : 91423-2343
Country : US
Telephone Number : 818-994-5373
Fax Number :
Provider Business Practice Location Address
First Line : 867 N FAIR OAKS AVE
Second Line :
City : PASADENA
State : CA
Zip : 91103-3050
Country : US
Telephone Number : 818-786-4673
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/29/2007
Last Update Date : 11/22/2023

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